An empirical study on 'how to retain rural teachers with emphasis on hygiene or motivation factors': A case of Western China.

How to retain prominent teachers is a fundamental problem for rural education in less developed countries. However, the critical institutional factors affecting teachers' turnover intention still need to be better understood. According to Herzberg's motivation-hygiene theory, this study examines the effects of hygiene factors (rural incentive policy, personnel policy, and teacher pay) and motivation factors (advancement, work itself, and achievement) on rural teachers' turnover intention. Based on a sample of 973 rural teachers, the results from structural equation modeling (SEM) showed that both hygiene factors and motivation factors can significantly reduce the turnover intention of rural teachers. Meanwhile, the effect of motivation factors is greater than that of hygiene factors. It was also confirmed that marital status, age, and teaching subject have a significant moderation effect on the relationship between motivation/hygiene factor and turnover intention, whereas gender has no significant moderation effect. Theoretical and practical implications for attracting and retaining rural teachers are discussed.

Successful treatment of epidermolysis bullosa pruriginosa by dupilumab.

Epidermolysis bullosa pruriginosa (EBP) is a rare variant of dystrophic epidermolysis bullosa caused by COL7A1 gene mutation. Intense pruritus and nodular prurigo-like lesions are the main features of the disease. To date, the treatment strategies for this condition are not well established. Recent studies have indicated that type 2 inflammation plays a role in the pathophysiology of EBP, suggesting Th2 cytokines could be potential therapeutic targets. In this prospective case series study, we reported three patients with EBP, diagnosed by clinical manifestations, histopathological evaluations, and genetic sequencing, two of whom were treated with dupilumab for 20 weeks. Results showed that the clinical symptoms, pruritus, and quality of life of the patients were significantly improved, as measured by the Epidermolysis Bullosa Disease Activity and Scarring Index, the Visual Analog Scale, and the Children's Dermatology Life Quality Index. Serum immunoglobulin E levels also fell gradually over the 20-week treatment period. Immunotyping of Th1/2/17 cell subsets in peripheral blood by flow cytometry revealed a higher Th2 but parallel Th1 and Th17 cell subsets in patients compared to healthy controls, and a significant decrease in Th2 and an increase in Th17 cells after dupilumab administration. Of note, after 20 weeks of dupilumab treatment, the expression of type VII collagen in the basement membrane of the skin lesion of the patients significantly increased, which was evidenced by immunofluorescence analysis. No treatment-related adverse events were documented. Taken together, targeting type 2 inflammation with dupilumab may be an effective and safe treatment option for EBP.